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pneumonia

This is a mind map about pneumonia. Pneumonia refers to inflammation of the terminal airways, alveoli, and pulmonary interstitium, which can be caused by pathogenic microorganisms and physical and chemical factors. Caused by immune damage, allergies and drugs.

Edited at 2023-12-15 14:52:33

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Outline

Medicine-Respiratory System Mind Map
- 18
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pneumonia

Concept: Pneumonia refers to inflammation of the terminal airways, alveoli, and pulmonary interstitium, which can be caused by pathogenic microorganisms, physical and chemical factors, immune damage, allergies, and drugs.

pathology

Normal respiratory immune defense mechanism

Integrity of intrabronchial mucus-ciliary transport system, alveolar macrophages and other cellular defenses

Whether pneumonia occurs depends on: pathogenic bacteria and host factors

Except for Staphylococcus aureus, Pseudomonas aeruginosa, and Glebsiella pneumoniae, which can cause necrotic lesions in the lung tissue and form cavities, most of the pneumonia will not leave any traces after it is cured, and the structure and function of the lungs can be restored.

Classification

anatomical classification

Lobar pneumonia (alveolar pneumonia)

The pathogen first forms inflammation in the alveoli and spreads to other alveoli through the inter-alveolar pores (Cohn pores), causing inflammation in some lungs. Inflammation occurs in segments or entire lung segments or lobes,

The typical manifestation is inflammation of the lung parenchyma, usually sparing the bronchi.

The causative bacteria are mostly Streptococcus pneumoniae

X-ray shows consolidation shadows in lung lobes or segments

Lobular pneumonia (bronchial pneumonia)

Pathogens invade through the bronchus and cause inflammation of the bronchioles, terminal bronchioles and alveoli.

Often secondary to other diseases, such as bronchitis, bronchiectasis, upper respiratory tract viral infection, and critically ill patients who are bedridden for a long time

The primary pathogens include Streptococcus pneumoniae, Staphylococcus aureus, viruses, Mycoplasma pneumoniae and Legionella

X-ray shows irregular patchy shadows distributed along the lung texture, with shallow and blurred edge density, without signs of consolidation, and the lower lobes of the lung are often involved.

interstitial pneumonia

Inflammation mainly in the pulmonary interstitium, involving bronchial walls and peribronchial tissues, with hyperplasia of alveolar walls and interstitial edema. Respiratory symptoms are mild, and breathing difficulties are obvious if the lesions are extensive.

Bacteria, Mycoplasma, Chlamydia, Viruses, Pneumocystis jiroveci

X-ray shows irregular shadows in the lower part of the lungs, which can be ground glass-like or grid-like, with small atelectatic shadows in between.

Cause classification

Bacterial

Streptococcus pneumoniae

Concept: Streptococcus pneumoniae pneumonia is caused by Streptococcus pneumoniae (SP) and accounts for about half of CAP. It usually has an acute onset and is characterized by chills, high fever, cough, bloody sputum and chest congestion.

pathology:

clinical

It is more common in winter and early spring, and is often accompanied by respiratory virus infection. The patients are mostly healthy young adults, the elderly, infants and young children, and it is more common in men.

symptom

There is a history of infection before the onset of the disease, often with prodromal symptoms of upper respiratory tract infection

The onset is sudden, with high fever, chills, and muscle aches all over the body. The body temperature rises to 39-40°C within a few hours, with the peak in the afternoon or evening, or it may be a banyan fever, and the pulse rate increases.

physical signs

Acute fever face, flushed cheeks, inflamed nose, burning and dry skin, herpes simplex at the corners of the mouth and around the nose

Cyanosis may occur in extensive lesions

Patients with detoxification syndrome may develop skin and mucous membrane bleeding spots and scleral jaundice.

increased heart rate

X-ray: In the early stage, increased lung texture is seen, or the affected lung segments and lobes are slightly blurred: lung consolidation shadows can show air bronchial sign, and there may be a small amount of pleural effusion at the intercostal angle. In the dissipation stage, the inflammatory infiltration is gradually absorbed, and there may be patchy areas that absorb quickly and appear as false cavities. Most of them completely dissipate within 3-4 weeks of the onset of disease. Pneumonia lesions in the elderly dissipate slowly and are easily absorbed incompletely, which is called organizing pneumonia.

staphylococcus

Concept: Pulmonary purulent inflammation caused by Staphylococcus aureus

Pathology: Staphylococci are Gram-positive cocci, which are divided into coagulation-positive Staphylococcus aureus (Staphylococcus aureus) and coagulation-negative Staphylococcus aureus (Staphylococcus epidermidis). bacteria and saprophytic Staphylococcus aureus). The causative substances are mainly toxins and enzymes (hemolytic toxins, leukocidal toxins, enterotoxins), which can destroy lung tissue

clinical

symptom

Frequent onset of acute illness, high fever and chills

Chest pain, purulent sputum, large amount, blood-streaked or purulent sputum

Symptoms of toxemia are obvious, including muscle and joint aches, physical weakness, and mental fatigue. In severe cases, peripheral circulatory failure may occur early.

physical signs

There may be no physical signs in the early stage, often not parallel with severe poisoning symptoms and respiratory symptoms, and then there may be scattered moist squeaking sounds in both lungs.

When the lesions are larger, lung consolidation, pneumothorax, and pyopneumothorax may occur.

X-ray: Chest X-ray shows consolidation of lung segments or lobes, which can form early cavities or lobular infiltrates, with single or multiple fluid-air cysts: shadows are variable, with inflammatory infiltrates disappearing in one place and new ones appearing in another. like, or a single lesion develops into a large shadow

Klebsiella pneumoniae

Overview: The elderly, those with underlying diseases, and the main causative bacteria of nosocomial pneumonia

pathology

Parasitic in the normal respiratory tract and intestines of the human body

If there is a British membrane, the proliferation in the alveoli can lead to tissue necrosis and liquefaction. The exudate from the lesion is thick and heavy, often causing the interlobar space to fall.

clinical

Symptoms: acute onset, high fever, cough, and sputum. The phlegm is thick and purulent, with a large amount of blood, and is brick-red and jelly-like.

Signs: Reduced breath sounds in the lungs, crackles or atelectasis may be present

X-ray: arc-shaped drop in leaf gap

Others: Legionella pneumonia, Pseudomonas aeruginosa

viral

Definition: caused by the downward spread of upper respiratory tract infection

Clinical: The disease is characterized by shallow breathing, increased heart rate, cyanosis, and wheezing in the lungs. Children and the elderly are prone to severe pneumonia.

Most likely to occur in spring and winter

interstitial pneumonia

other

disease environment

Hospital-acquired pneumonia HAP

No invasive mechanical ventilation was received during the hospital period, the pathogen was not in the incubation period, and new pneumonia occurred in the hospital 248 hours after admission.

Common pathogens Gram-negative bacilli: Pseudomonas aeruginosa, Glebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii; Staphylococcus aureus

community-acquired pneumonia CAP

Pneumonia acquired outside the hospital, including pathogenic infections with a clear incubation period, which develop within the incubation period after admission

Common pathogens Streptococcus pneumoniae, Mycoplasma, Chlamydia, Haemophilus influenzae, viruses

Diagnosis and treatment

Diagnosis: Confirm the diagnosis of pneumonia (distinguish between upper and lower respiratory tract infections and other lung diseases), assess the degree of inflammation, CAP severe pneumonia

Treatment: Anti-infective treatment (the earlier the key link, the better)

Empirical treatment: Choose antibiotics that cover possible pathogens based on the epidemiological data of pneumonia pathogens in the local area and unit.

Antipathogen treatment: Select antibiotics that are sensitive to in vitro testing based on culture and susceptibility testing results of respiratory tract or lung tissue specimens